Agenda and draft minutes

Health and Wellbeing Board
Wednesday, 29th May, 2019 2.00 pm

Venue: Ground Floor Committee Room - Loxley House, Station Street, Nottingham, NG2 3NG

Contact: Kate Morris  Email: kate.morris2@nottinghamcity.gov.uk

Items
No. Item

1.

Change in Membership

To note the following changes in membership:

 

Current Member

Organisation

New member

Councillor Sam Webster

Councillor David Mellen

Vacancy

Nottingham City Council

Nottingham City Council

Nottingham City Council

Councillor Eunice Campbell-Clark

Councillor Adele Williams

Councillor Leslie Ayoola

Superintendent Ted Antill

Nottinghamshire Police

Superintendent Matthew Healey

Tracey Taylor

Nottingham University Trusts

Alison Wynne

Hazel Buchanan

Greater Nottingham Clinical Commissioning Group

Andrea Brown

 

Minutes:

RESOLVED to note the following membership changes:

 

Current Member

Organisation

New member

Councillor Sam Webster

Councillor David Mellen

Vacancy

Nottingham City Council

Nottingham City Council

Nottingham City Council

Councillor Eunice Campbell-Clark

Councillor Adele Williams

Councillor Leslie Ayoola

Superintendent Ted Antill

Nottinghamshire Police

Superintendent Matthew Healey

Tracey Taylor

Nottingham University Trusts

Alison Wynne

Hazel Buchanan

Greater Nottingham Clinical Commissioning Group

Andrea Brown

 

 

2.

Apologies for absence

Minutes:

Councillor Leslie Ayoola – Nottingham City Council

Dr Marcus Bicknell – CCG

Jane Todd – Nottingham CVS

Alison Wynne – NUH Trust

 

3.

Declarations of interests

Minutes:

None.

4.

Obesity pdf icon PDF 211 KB

Report of the Director of Public Health

Additional documents:

Minutes:

David Johns, Acting Consultant in Public Health, introduced the themed discussion on Obesity. He gave the Board an overview of Obesity in Nottingham City, which has increased in recent years, outlining the correlation between high levels of deprivation and high levels of obesity in children in Nottingham. David emphasised the need for a whole system approach, incorporating partner organisations and stakeholders in order to tackle the issue.


Caroline Keenan, Insight specialist for Public Health presented the Board with information on the new adult weight management services available in Nottingham. She highlighted the following points:

 

(a)  There are 4 tiers of weight management provision for adults, the first 2, health promotion & primary care and lifestyle interventions are primarily the responsibility of the local authority. The third and fourth tiers, including specialist weight management services and bariatric services are traditionally the responsibility of health care trusts.

 

(b)  Nottingham City Council currently offers two interventions, Slimming World weight management on referral and Ladle, a digital weight management course.

 

(c)  Eligibility for referral to Slimming World is based on BMI, includes 12 weekly classes and is available across the city at various different times of the day. Priority groups include:

·  People with learning disabilities

·  People with mental health problems

·  Pregnant women

·  People of African, Caribbean or South Asian descent; and

·  Men.

 

Mark Fulford, Facilities Manager (Catering) for Nottingham University Hospitals detailed to the Board work ongoing within the Trust to improve the food offering for staff visitors and patients. He highlighted the following points:

 

(d)  There are 4 trust wide standards which all catering outlets are subject to:

·  A ban of price promotions on sugary drinks and foods high in fat, sugar or salt.

·  A ban on advertising sugary drinks and foods high in fat, sugar or salt on NHS premises.

·  A ban on sugary drinks and foods high in fat, sugar or salt from check out areas

·  Ensuring that healthy options are available at any point, including those staff working night shifts.

 

(e)  Other standards introduced ensure that at least 75% of prepacked sandwiches and other savoury prepacked meals contain 400kcal or less per serving, and do not exceed more than 5g saturated fat per 100g and that 80 % of confectionary and sweets do not exceed 250kcal;

 

(f)  Going forward there are a number of initiatives taking place to continue to theme of healthy eating within NUH trust. A fruit a veg stall will be introduced onto the City and QMC Campus’. There will be continued work with retail partners to deliver the standards set out above and checks and audits to ensure that the maintained.

 

Gemma Poulter, Head of Integration – Adult Social Care and Amanda Chambers, Getting Active Strategic Lead introduced information to the Board on the Sport England local delivery pilot aimed at reducing physical inactivity.

 

Gemma presented the story of a citizen who had a long term condition which had led to her becoming increasingly inactive. She detailed her meeting with a community activator, who spoke to  ...  view the full minutes text for item 4.

5.

Health and Wellbeing Strategy Annual Update pdf icon PDF 197 KB

Report of the Director of Public Health

Additional documents:

Minutes:

Uzmah Bhatti, Insight Specialist (Public Health) Strategy and Resources introduced the Annual update report 2019 on the Joint Health and Wellbeing Strategy 2016-2020 providing the Board with an update on strategic developments. She bought the following points to the attention of the Board:

 

(a)   The strategy is divided into 5 areas, an overarching aim to increase healthy life expectancy in Nottingham and 4 outcomes which are then further broken down into different indicators: 

·  Healthy lifestyles

·  Mental wellbeing

·  Healthy culture

·  Healthy environment

 

(b)  Healthy life expectancy in Nottingham is lower than comparators for both men and women. This figure has not changed for men but has shown a downward trend women since targets were set;

 

(c)  When targets were set, there were significant differences between neighbourhoods in Nottingham with people in the most socio-economically deprived wards experiencing poorer health earlier than those in less deprived wards.  Further ward level data is not available to analyse whether there has been a greater impact at ward level.

 

(d)  The Healthy Lifestyle Outcome indicators updates include the following key points:

·  Although rates of sexually transmitted infection remains high in Nottingham, there has been no statistically significant increase since baseline.  Actions are being taken to address challenges around rising demand and higher needs in groups such as young people.

 

·  There has been significant progress and the conception rate amongst girls age 15-17 has decreased approximately 15% since baseline. Further system-wide actions are being identified to sustain this downward trend.

 

·  Alcohol related hospital remain unchanged and are higher than comparators. A number of work streams are in progress to reduce this number, including funding bids for an Alcohol Hub in emergency departments and for accommodation to help “street drinkers”.

 

·  Targets around reducing smoking amongst adults have been achieved.  Persistent and vulnerable smokers are now to focus of a new smoking cessation service.

 

· Obesity is an ongoing national issue. This has been discussed at length in minutes 4.

 

(e)  Service related targets for mental health have been achieved.  In addition to this, Time to Change hub has over achieved on targets. Activity target at people with serious mental illness, BME people and construction workers is being progressed.  A refreshed strategy is currently out for consultation

 

(f)  Healthy Culture targets around askLION and reablement have been met and exceeded.  However, targets around hospital discharge and financial resilience have been more challenging.  Actions are being taken to address these.  

 

(g)  Good progress has been made in the Healthy Environment Outcome. Air quality has been improved and  EMAS has reduced their carbon footprint. There is still work to do around reducing the number of households in fuel poverty and excess winter deaths as is the case across most of the core cities; Policy restricting hot food outlets near secondary schools has had to be removed due to challenges.  Transport improvement continues with various initiatives funded by external sources.

 

During questions and comments from the Board the following further points were highlighted:

 

(h)  There has  ...  view the full minutes text for item 5.

6.

Primary Care Networks pdf icon PDF 276 KB

Report of the Associate Director of Joint Commissioning and Planning, Greater Nottingham Clinical Commissioning Partnership 

Additional documents:

Minutes:

Andrea Brown, Associate Director of Joint Commissioning and Planning for Greater Nottingham Clinical Commissioning Group introduced the report on Primary Care Networks (PCN’s) to the Board setting out the development of PCN’s. The following information was highlighted:

 

(a)  Since Nottingham and Nottinghamshire became one of the first wave of Integrated Care Systems in 2018 Nottingham City CCG and the other 5 CCG’s within Nottingham and Nottinghamshire have been working towards aligning teams and functions;

 

(b)  The PCN’s will focus on service delivery with responsibility for planning and funding of services remaining with the commissioner;

 

(c)  A PCN will be a group of practices working together with a range of local providers across primary care, community services, social care and the voluntary sector and it will offer more personalised coordinated health care;

 

(d)  PCN’s broadly fit with the Nottingham City Council Ward Boundaries and have a similar configuration as the Care Delivery Groups previously established;

 

(e)  The CCG’s aim is to form a single CCG as the strategic commissioning organisation within the Nottingham and Nottinghamshire ICS, which will work alongside a number of other changes to NHS services outlined in the NHS Long Term Plan;

 

(f)  A consultation process is currently taking place on this merger and input from Board members would be welcomed;

 

RESOLVED to:

 

(1)  Help raise awareness of the plans for the Primary Care Networks and the different levels of the ICS in order to build a consistent and shared understanding of how the system will work together to improve health and care in Nottingham City; and

 

(2)  Consider the role that partners could play in the development and implementation of the PCNs.

7.

Impact of the Commissioning Reviews 2018/19 pdf icon PDF 293 KB

Report of the Director of Public Health

Additional documents:

Minutes:

Christine Oliver, Head of Commissioning, introduced the report updating the Board on the progress to date on the Commissioning reviews for Nottingham City Council and the joint priorities for NCC and Nottingham City CCG for 2018-19. The following points were highlighted during discussion:

 

(a)  A new inpatient contract was tendered resulted in a new in patient detoxification contract being awarded.  A new contract is due to commence a the beginning  of July 2019.

 

(b)  Work around Homelessness continues with a number of new contracts introduced at the beginning of 2018/19 and a new service model implemented. These services include those aimed at reducing the risk of homelessness and a greater number of households at risk of homelessness have been supported into accommodation that is more appropriate. Further work continues;

 

(c)  Following the review of Domestic and Sexual Violence Services additional funding was  secured which has allowed additional provision including 24hour domestic helpline, a male IDVA service and 3 specialist domestic violence refuge provision;

 

(d)  Many of the joint reviews are still being undertaken and will continue into 2019/20. This includes reviews of Mental Health services where there is currently a lot of pressure;

 

(e)  The Transforming Care Programme is an ambitions and complex programme. The joint review is taking place closely with NHS England;

 

RESOLVED to note the progress made in relation to last year’s Strategic Commissioning Priorities

 

8.

Commissioning Intentions 2019/20 pdf icon PDF 213 KB

Report of the Director of Public Health

Additional documents:

Minutes:

Christine Oliver, Head of Commissioning, updated the Board on the Commissioning Intentions for 2019/20. She set out the intentions of Nottingham City Council (NCC) and the Joint intentions of Nottingham City Council and Nottingham City Clinical Commissioning Group (CCG) which will form the basis of the work programme for both organisations. She highlighted the following information contained within the report:

 

(a)  Although there is work occurring around mental health services a clear pathway for services is  yet to be established . Catherine Underwood, Hugh Porter and John Brewin  will take this work forward and align it to the Integrated Care Partnership for the city. This includes transformation of CAMHS services and the development of an integrated Mental Health Accommodation Pathway;

 

(b)  A new homecare model is in place which forms part of the Adult Social Care  Better Lives Better outcomes agenda;

 

(c)  The Better Care Fund and improved Better Care Fund supporting integration of provision between Health and Social Care continues to focus on Delayed Transfers of Care from hospital to the community;

 

RESOLVED to note the main areas of activity identified within the Commissioning Plans.

9.

Board Member Updates

Minutes:

Board member updates were noted.

9a

Third Sector

9b

Healthwatch Nottingham and Nottinghamshire

9c

NHS Greater Nottingham Clinical Commissioning Partnership pdf icon PDF 204 KB

9d

Nottingham City Council Corporate Director for Children and Adults and Director for Adult Social Services pdf icon PDF 217 KB

Report of the Corporate Director for Children and Adults and the Director of Adult Social Services

Additional documents:

9e

Nottingham City Council Director for Public Health pdf icon PDF 290 KB

10.

Minutes pdf icon PDF 244 KB

To confirm the minutes of the meeting held on 27 March 2019

Minutes:

The minutes of the meeting held on 27 March 2019 were confirmed as a true record and were signed by the Chair.

11.

Forward Plan pdf icon PDF 193 KB

Minutes:

RESOLVED to note the forward plan

12.

Action Log pdf icon PDF 298 KB

Additional documents:

Minutes:

The Chair asked that all members review the action plan and provide updates on outstanding actions.

13.

Minutes of the Health and Wellbeing Board Commissioning Sub Committee held on 27 March 2019 (Draft) pdf icon PDF 128 KB

For information only

Minutes:

RESOLVED to note the draft minutes of the Health and Wellbeing Board Commissioning Sub Committee held on 27 March 2019.

14.

New Joint Strategic Needs Assessment Chapters - Demography and Pregnancy pdf icon PDF 222 KB

Additional documents:

Minutes:

RESOLVED to note the new Joint Strategic Needs Assessment Chapters Demography and Pregnancy.

15.

Questions from the public

Opportunity for members of the public to ask questions relating to matters within the Health and Wellbeing Board’s remit.

 

The maximum amount of time allocated to questions and responses is 30 minutes.

Minutes:

None.

16.

Future Meeting Dates

To confirm the future meeting dates of the Health and Wellbeing Board for the municipal year 2019/20:

 

24 July 2019

25 September 2019

27 November 2019

29 January 2020

25 March 2020

Minutes:

RESOLVED to meet on the following Tuesdays:

 

24 July 2019

25 September 2019

27 November 2019

29 January 2020

25 March 2020